title: Dietary fiber and the risk of precancerous lesions and cancer of the esophagus: a systematic review and meta-analysis.
abstract: Dietary fiber has several anticarcinogenic effects and is thought to be protective against esophageal cancer. The aim of this systematic review was to quantify the association between dietary fiber and the risk of esophageal cancer by investigating histological subtypes of esophageal cancer and the stage at which fiber may influence the carcinogenic pathway. Systematic search strategies were used to identify relevant studies, and adjusted odds ratios (ORs) were combined using random-effects meta-analyses to assess the risk of cancer when comparing extreme categories of fiber intake. Ten relevant case-control studies were identified within the timeframe searched. Pooled estimates from eight studies of esophageal adenocarcinoma revealed a significant inverse association with the highest fiber intakes (OR 0.66; 95% confidence interval [CI] 0.44-0.98). Two studies also identified protective effects of dietary fiber against Barrett's esophagus. Similar, though nonsignificant, associations were observed when results from five studies of fiber intake and risk of squamous cell carcinoma were combined (OR 0.61; 95%CI 0.31-1.20). Dietary fiber is associated with protective effects against esophageal carcinogenesis, most notably esophageal adenocarcinoma. Potential methods of action include modification of gastroesophageal reflux and/or weight control.
authors.affiliation: Cancer Epidemiology & Health Services Research Group, Centre for Public Health, Queen's University Belfast, Belfast, Northern Ireland. h.coleman@qub.ac.uk
authors.forename: Helen G
authors.initials: HG
authors.lastname: Coleman
authors.forename: Liam J
authors.initials: LJ
authors.lastname: Murray
authors.forename: Blanaid
authors.initials: B
authors.lastname: Hicks
authors.forename: Shivaram K
authors.initials: SK
authors.lastname: Bhat
authors.forename: Ai
authors.initials: A
authors.lastname: Kubo
authors.forename: Douglas A
authors.initials: DA
authors.lastname: Corley
authors.forename: Chris R
authors.initials: CR
authors.lastname: Cardwell
authors.forename: Marie M
authors.initials: MM
authors.lastname: Cantwell
mesh_terms: D000230:Adenocarcinoma / Q000453:epidemiology / Q000517:prevention & control*; D016588:Anticarcinogenic Agents / Q000008:administration & dosage*; D004032:Diet; D004043:Dietary Fiber / Q000008:administration & dosage*; D004938:Esophageal Neoplasms / Q000453:epidemiology / Q000517:prevention & control*; D006801:Humans; D011230:Precancerous Conditions; D012307:Risk Factors
chemical_list: D016588:Anticarcinogenic Agents; D004043:Dietary Fiber
keywords: Barrett's esophagus; dietary fiber; esophageal adenocarcinoma; esophageal squamous cell carcinoma